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COMAR 10.09.24.04

326 State of Maryland Medical Assistance Manual Revised July 2012

coverage or both. 2. Verification-When an applicant files a completed application form for MA coverage, verification of all elements of current or retroactive eligibility or both are required.

a. Current eligibility- When an applicant meets the requirement to complete all application form and requests coverage for the current period, verification of all elements of eligibility is required for the current period.

b. Retroactive Eligibility- When applicant meets the requirement to complete the application form and requests coverage for the retroactive period only, but does not provide verification of elements for the current period, he/she may be determined ineligible for the retroactive period only if he/she fails to provide verification of elements are pertinent to the determination of eligibility for the retroactive period.

(2) Disposition of Application

An applicant must provide all required information/verification early enough to allow for a decision by the LDSS within the 30 or 60 day time frame. The applicant is determined ineligible when he/she fails to provide all required information/verification within the time frame. If the applicant complete the application form and verifies all elements of eligibility for the retroactive period but does not verify all elements for the current period, certify for the retroactive period., if current ineligibility exists because of failure to verify, ODO the application for that period. If the person reapplies, follow the applicable procedures in Section F “Reapplication following a decision of ineligibility.”

An applicant may voluntarily withdraw his/her application for MA.

Period under consideration ( reactivation) expires

A request and application filed for MA after the expiration of the original period under consideration will be considered New Application. Nor part of the expired current period under consideration may be converted to a retroactive period since the person has already applied for those months as part of the current period. However, the incurred unpaid expenses from the expired period may, with the written consent of the applicant, be applied to excess income, if any for the new current period. The DHMH form 4284, “Authorized to Apply Incurred Medical Expenses from an Expired Period to the Current Period”, is signed and dated by the applicant and CM. This authorization is required in situations of ineligibility for reasons other than technical ineligibility or excess resources. Incurred expenses from a retroactive period of ineligibility for technical reasons or excess resources may be applied to excess income for a current period, if any without written authorization.

Example:

Application is filed on 9/15/2011. An earlier application was filed on 1/15/2011 and rejected due to insufficient income information. The initial period under consideration is 1/2011 through 6/2011 and has expired. Therefore, the new application, 9/15/2011, establishes both the date of application and current period under consideration ( 9/2011-2/2012).